Please mail this completed form AND the HIPAA Release form to:Ben’s Ranch Foundation, Inc.PO Box 3952, Carmel, IN 46082Or email completed form to Brose McVey, at [email protected]
![18287_Ben’s_Ranch_Images_Host_Families[1]](https://bensranch.org/wp-content/uploads/2017/02/18287_Bens_Ranch_Images_Host_Families1.png)